Provider Demographics
NPI:1700935038
Name:KOBTY, NADINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:NADINE
Middle Name:
Last Name:KOBTY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 US HIGHWAY 131 S
Mailing Address - Street 2:P.O. BOX 889
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-8437
Mailing Address - Country:US
Mailing Address - Phone:231-775-9797
Mailing Address - Fax:231-775-9793
Practice Address - Street 1:7800 US HIGHWAY 131 S
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8437
Practice Address - Country:US
Practice Address - Phone:231-775-9797
Practice Address - Fax:231-775-9793
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI18146122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI124993562Medicaid